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Health in Our Hills
The United States is facing an aging population, a mass addiction crisis and a country-wide shortage of bedside nurses. The WVU School of Nursing program in Beckley is working to do something about it.
Matt Lechalk was pushing an empty bed down the long, bright corridor when he heard the commotion. A new patient – a very large new patient – was wrestling with security guards at the other end of the hall. The squabble was loud and violent, and where Matt was standing, he could see it wasn’t going well.
As Matt dashed toward the fighting, he saw the man bite a guard. When he reached
the group, he pushed his hand into the man’s upper lip and nose, causing him
to release his bite. It’s a pressure point Matt learned in his Aikido martial
arts class, and it allowed him to help the guards restrain the new patient.
But in the twenty minutes or so that followed, it wasn’t martial arts that helped to diffuse the dangerous situation.
It was good bedside manner.
Matt is a senior nursing student from Fayetteville, West Virginia. During that tense half hour, he relied on everything he had learned in the program. He assisted the doctors as they worked to stabilize the unruly guest. He talked with the patient and helped him calm down enough to get through a CT scan. Then he helped the man get to his room and settle in.
For Matt, it was one of the most memorable experiences of his new nursing career.
Building a better nurse
Matt is one of many students who are learning the nursing trade at WVU Tech.
The program has seen incredible growth in the last few years, both in enrollment and in capability.
Dr. Crystal Sheaves is chair of the department, which offers WVU’s nationally accredited nursing program on Tech’s campus in Beckley.
She’s a professor, too, and when she talks about the field, there’s no mistaking her passion for the program.
“We’re seeing so many bright, capable students. We went to 33 students this year from 24 last year and 15 the year before,” she said.
While 33 doesn’t seem like a staggering class, it’s a big deal for healthcare in Southern West Virginia.
“There is a major shortage of bedside nurses in the state and, indeed, in the country,” said Sheaves.
It’s true. The U.S. Department of Labor’s Bureau of Labor Statistics projects more than a million open RN positions nationwide by 2024. Last December, the State Journal reported that the Mountain State is facing its “worst ever” shortage. The piece pointed to the prevalence of travel nurses filling vacancies in the state.
That makes homegrown nurses worth their weight in gold, and Sheaves, a gold miner.
“We have the students we need right here, and we’re doing everything we can to make sure they’re ready to take on careers,” she said.
That training starts on day one. The program is taught by instructors with real bedside experience. It offers students access to high and low-fidelity labs, complete with technology-imbued manikins. There’s state-of-the-art medical equipment, too.
It’s all part of the program’s efforts to modernize in the last two years.
“We can simulate an actual hospital experience where the patient is having a cardiac or respiratory arrest. We have cameras installed so we can put students in a simulated scenario and debrief them in the classroom. It’s a very effective teaching tool,” she said.
Nursing students will also take part in externships and clinical rotations in the course of their training.
“Our students are exposed to a wide range of clinical settings. They get to work in big hospitals and smaller facilities so they can see different types of patients. We offer clinical work in Charleston, Beckley, Lewisburg and Oak Hill,” said Sheaves.
Sheaves said those opportunities will grow to keep pace with the expanding program and with changes in modern health care.
“I’ve already arranged extra clinical spaces,” said Sheaves. “And we’re trying to change with the times. A lot of patient work is being done at home or on an outpatient basis, so we’re looking at adding some outpatient clinical observation experiences for our students.”
All that hard work is paying off. In 2018, nursing grads reported a 100% passage rate on the NCLEX exam, and every graduate from the class is already working in the field.
That’s a big deal for prospective students like Caelea Teel. She’s a junior from Oak Hill, West Virginia, who started her nursing career in Morgantown.
“When I was considering transferring to Tech, I discovered that the most recent graduating class at that time had a 100% pass rate on the NCLEX. That was a huge factor in my final decision,” she said.
Caelea knew she wanted to be a nurse since she was in middle school.
“I would talk to my grandmother who was a nurse and hear about some of her experiences. Nursing fascinates me because there are so many different directions you can take your career and nurses are always needed,” she said.
Now she’s using her passion in the field. She’s already completed an operating room rotation where she was able to watch surgeries performed. She’s working in an externship at Beckley Appalachian Regional Healthcare Hospital. She’ll also spend her time this semester with much younger patients as she completes labor and delivery rotations.
An elephant in the ER
Building a powerful nursing program in Beckley doesn’t come without challenges.
“Geography in Southern West Virginia is a major hurdle,” said Sheaves. “We don’t have a lot high-acuity resources for seriously ill patients at our fingertips, so we often have to refer patients to facilities in Charleston, Morgantown, Huntington or Charlottesville. That’s a big challenge for nurses and physicians practicing in this area.”
Then there’s what Sheaves calls the profession’s “elephant in the room.”
Opioid addiction has changed the face of health care in Southern West Virginia. While the topic is receiving national attention, Sheaves said that nurses are on the forefront of the epidemic.
“It touches everyone here in some form or fashion. We have nurses who have been impacted in their lives and we have nurses who are currently working in substance abuse treatment centers,” she said.
Sheaves herself works in a clinic run by the Greenbrier County Health Department.
“On Tuesdays, they have patients come in to do a needle exchange. They use that opportunity to counsel them on seeking help and how to reduce harm. These centers are also referring addicts into primary care where they weren’t receiving any care before,” she said.
She says the practice keeps her sharp and up-to-date. It keeps her in the trenches. But she also knows it’s something every one of her students will deal with as they move into their careers.
Even so, she knows they’re ready.
To be a nurse
In an environment with limited resources and where overdoses can sometimes outnumber nurses, there are going to be hard days. But that’s what drives these students. They want to help, and they certainly plan to.
“Nurses are patient advocates. We speak up for what our patients need,” said Caelea, who wants to go on to be a neonatal nurse practitioner and share her passion with the community.
“I will be treating patient responses to illnesses, providing emotional support and teaching patients and the community about health and safety issues. These things will help make a positive impact in Southern West Virginia,” she said.
Matt, who wants to build a career as a nurse practitioner in the ER, finds inspiration in the work, too.
“Sitting with a patient who hasn’t any family, just to hear their story. Taking a knee to get on the same level with the patient and sharing a laugh. These are some of what keeps me coming back. These are the things I love about the field I’ve chosen,” he said.
This is what encourages Sheaves. There’s more work to be done, but today, she’s beyond proud of how far the program has come.
She should be. She’s part of a team that is building better nurses right here at home – a new generation of smart, capable and compassionate people who hope to change the story of health care in the coalfields.
To hear them talk about it, it’s going to be a great story. A happy one, with lots of characters.
“I do not expect to make a big impact alone,” said Matt.
“Having a strong force of likeminded nurses will be what makes the impact measureable, and I look forward to becoming a part of them.”